Ask Dr. Darria: Breastfeeding Has Become Painful. What Can I Do?

Ask Dr. Darria: Breastfeeding Has Become Painful. What Can I Do?

I want to breastfeed my baby, but my nipples have become sore and I’m starting to dread nursing her. I thought this was supposed to be a positive, bonding experience.

Congratulations! You’ve just brought home your new baby.  Now she’s hungry, and you’re sore from breastfeeding. What can you do?

As a very wise source once told me, breastfeeding may seem daunting for a new mom, but “even if you don’t know what to do, you can be sure that your baby DOES know.”  So don’t give up just yet. Let’s look at the basics and then find some ways to help.

What’s the right amount of time to breastfeed?
Current recommendations are to feed only breast milk for the first 6 months, and then from month 6-12 feed your baby a combination of breast milk and foods such as cereal, fruit and veggies for babies.

Why should I breastfeed?
Research has shown many benefits -- for both you and your infant:

For the baby:

  • Better nutrition
  • Reduces risk of infection: Newborns have a very weak immune system (trust me, I see them in the ER!).  When you breastfeed, you actually pass on antibodies from your own immune system, protecting your child from illness.  Babies that are breastfed have lower rates of hospitalization and decreased respiratory, ear and urinary tract infections
  • Psychological well-being: studies show that it reduces pain and stress in the infant
  • Reduced risk of obesity: breastfeeding for at least 6-7 months may reduce a child’s risk of being overweight, according to another recent study

For you:

  • Decreased uterine bleeding after birth
  • Less stress
  • More rapid weight loss
  • Lower feeding costs (formula is expensive!); fewer sick baby doctor’s visits; less missed work for you
  • Breastfeeding for 6-12 months has been shown to reduce your risk of breast cancer, particularly in women who don’t smoke

Related: 4 Best Ways to Hold Your Baby for Breastfeeding

What are common causes of breast pain and what can you do to alleviate them?

Engorgement: When your breasts are too full of milk and your baby has trouble latching on, breasts can become swollen, hard and painful.

  • Use a breast pump to let out milk for 2-5 minutes (no longer, or you could make it worse)
  • Use an ice pack, take a warm shower, or try gentle massage until milk starts to flow
  • Take Tylenol to reduce pain

Painful nipples: possibly due to cracks, blisters or bruises.

  • Make sure that baby is latching on correctly
  • Use a doctor-prescribed ointment
  • Try an over-the-counter ointment, such as lanolin
  • Wear breast pads between feedings to keep nipples from rubbing against fabric

Blocked milk ducts: these can cause a painful and red lump.

  • Try to breastfeed often, and make sure that the breasts fully empty during feedings.
  • Try a warm shower and gentle massage to help milk flow

Breast infections: this is a common reason that many breast-feeding women come to the ER or see their doctors.  The most common infection is called “mastitis.” In addition to a fever, you may develop a hard, red and swollen area on your breast.

  • You don’t need to stop breast-feeding while you have mastitis
  • Take a pain reliever like acetaminophen
  • Use a breast pump to fully empty your breast after feedings
  • Talk to your doctor to see if you should take an antibiotic (and make sure to find out whether you can continue feeding your baby while on the antibiotic)

When should I see a doctor?
If you have a blocked duct that doesn’t improve after three days, have a fever and signs of mastitis, blood coming from your nipples or pain that lasts for an entire breast-feeding session, check in with your OB/GYN.

For more information, or if you’re just having trouble, ask your doctor to recommend a “lactation consultant” -- someone who’s specially trained to help you deal with problems and successfully breastfeed your baby.

Medically reviewed in May 2018.

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